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Posted 9/28/2018 7:47 AM (GMT 0)
I know this is a little off topic but has anyone here had blood results come back saying they have nucleated red blood cells?

Was it the result of ulcerative colitis induced anemia?

I'm still waiting on a phone call about my tpmt results (for Imuran) but I imagine this is a spanner in the works with any bone marrow concerns..

😔
Posted 9/28/2018 1:13 PM (GMT 0)
Not so familiar with "nucleated red blood cells," myself. I do know anemia is rather common with us. One of the more common extra-intestinal-manifestations of UC. Many here have posted about anemia over the years. I don't have an anemia myself, but my RBCs are certainly bigger than normal which leans in that direction but not significant enough to be it; officially.

The TPMT test is a good idea.
Posted 9/29/2018 4:57 AM (GMT 0)
Are you on sulfasalazine by chance? I know that drug is linked to some less-common side effects including RBC abnormalities. I actually re-tried sulfa myself a while back, as I think that (for me at least) it works better than the 5-ASAs. In my case, however, I ended up having "Howell Jolly Bodies" (nucleus fragments I believe) found after my next routine blood test. I was feeling fine at the time. At first we were all stumped and a little concerned that there was a problem with my spleen. Then we read more about the sulfa side effects, some of them having to do with RBC morphologies, and figured we would temporarily stop that drug and move back to 5-ASAs. Sure enough, a month or so later I had my blood re-tested and it was back to normal. Have stayed on 5-ASAs (Colozal) and haven't had RBC problems since... knock on wood!

So far as I'm aware, Imuran does often cause increased RBC size. I have also seen this myself. However that is more "normal" and is generally no cause for concern, so far as I'm aware.

Best of luck and I hope that this turns out to be nothing of major significance. That said, I would deifnitely follow Dr.'s recommendations here and get whatever test(s) he/she orders done to make sure.
Posted 9/29/2018 9:53 AM (GMT 0)
RocketMan12 that is actually very interesting.

I'm currently only on prednisone 30mg and mesalazine 4g daily (only recently diagnosed, never taken anything else). I'll create a signature thing on my profile for that.

Yes I'm a little worried its my bone marrow or spleen but hoping perhaps an anemic reaction to the flare that put me in hospital.

Post Edited (Bloodyhell) : 9/29/2018 7:14:16 AM (GMT-6)

Posted 9/30/2018 1:42 AM (GMT 0)
Wikipedia says that it is because the bone marrow is releasing immature RBC because of demand is high. Normally mature RBC have no nucleus. If they have a nucleus it means they were pushed out by the bone marrow before they could become proper adults. It happens in anemia when the demand for blood is high, and during inflammation.

I can see how this would be related to UC. You're bleeding a lot and using up a lot of iron in the process so maybe they are NRBC because the body would rather have as much RBC in circulation as possible, even if they're not mature yet. Better to have immature ones than none.
Posted 9/30/2018 2:45 AM (GMT 0)
Did they report the number of Nucleated RBC's? The quantity could make a difference.

There is another common test, the reticulocyte count that also gives an idea of red cell maturity.

Let us know what a repeat CBC shows.
Posted 9/30/2018 10:29 AM (GMT 0)
naturalcurl, paperwork stated it was only 1/100 so not very high at all. Likely anemia, I'm thinking.

I'm interested to see what my next bloods say.
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